Organization
CAPITAL REGION MEDICAL CENTER
Active
Organization
CAPITAL REGION MEDICAL CENTER
Active
Other names
Capital Region Physicians - CCMA
Organization subpart
No
Provider details
NPI number
Authorized official
TOM LUEBBERING (VP OF FINANCE)
(573) 632-5100
Entity
Organization
Contact information
Practice address
1505 SOUTHWEST BLVD, JEFFERSON CITY, MO 65109-2431
(573) 634-2620
(573) 634-2033
Mailing address
PO BOX 1128, JEFFERSON CITY, MO 65102-1128
(573) 634-2620
(573) 634-2033
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RN0300X
Nephrology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207RR0500X
Rheumatology Physician
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
05/29/2008
Last updated
08/23/2013
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